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MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-IfI-O~( <br />C.O. NO.: <br />N.O.V. NO.: C-9~ - ooz <br />I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED AMOUNT <br />OF CIVIL PENALTY on the operator therein described by <br />y eposi ting a rue copy t;~ereof <br />firs c ass pos age prepaidin the ni ed States mails at Denver, Colorado, <br />addressed to the operator at the address above, on FP/, / ~ 19~ <br />~gnature o erson rve <br />if personal service <br />rin ame an r e <br />Certified Mail No.: P fart`' Ski ~Y6 <br />Return Receipt Reques e <br />n c <br />' igna re <br />L 4L7V ~~~71`t'% , /~ Sf PSfIStPK~~~['E, <br />~ri~R roe arnd"7i~ e <br />* ---- Check applicable method of service. <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement <br />conference as permitted by C.R.S. 34-33-123(9). <br />Operator <br />By <br />igna re <br />Date 19 <br />05/90 <br />0311 (f) <br />